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Analizar Consumos y Prestaciones}{\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow0\irowband0 -\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb -\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\trowd \irow1\irowband1\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 -\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\pard -\ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 -\par }{\b\f37\fs20\noproof0\insrsid4072389 Actores: }{\f1\fs20\insrsid331756 Prestador}{\f1\fs20\insrsid9206653 , Pagos.}{\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { -\f37\noproof0\insrsid4072389 \trowd \irow1\irowband1\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 -\clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 - -\par }{\b\f37\fs20\noproof0\insrsid4072389 Precondiciones: }{\f37\fs20\noproof0\insrsid1194460 Existe alg\'fan tipo de comunicaci\'f3n entre }{\f37\fs20\noproof0\insrsid331756 el}{\f37\fs20\noproof0\insrsid1194460 }{\f37\fs20\noproof0\insrsid331756 -Prestador y el Sistema, que permita a}{\f37\fs20\noproof0\insrsid1194460 l }{\f37\fs20\noproof0\insrsid331756 Prestador}{\f37\fs20\noproof0\insrsid1194460 enviar informaci\'f3n hacia \'e9ste \'faltimo}{\f37\fs20\noproof0\insrsid10759101 ; as\'ed como - entre el Sistema y Pagos.}{\f1\fs20\insrsid4072389\charrsid1194460 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow2\irowband2\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 -\trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 -\cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 -\par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 {\b\f37\fs20\noproof0\insrsid1275109 Poscondiciones}{\b\f37\fs20\noproof0\insrsid4072389 : }{\b\f37\fs20\noproof0\insrsid9206653 -\par }{\f1\fs20\insrsid9206653 Historia cl\'ednica de los a}{\f1\fs20\insrsid5514698 filiados afectados actualizada.}{\f1\fs20\insrsid9206653 -\par \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de }{\f1\fs20\insrsid10759101 la info enviada por el prestadort acerca de }{\f1\fs20\insrsid9206653 prestaciones}{\f1\fs20\insrsid10759101 realizadas.}{\f1\fs20\insrsid9206653 -\par \'c1rea de Pagos dis}{\f1\fs20\insrsid662813 pone de los reportes de consumo de los afiliados.}{\f1\fs20\insrsid9206653 -\par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow3\irowband3 -\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb -\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 -\par }{\b\f37\fs20\noproof0\insrsid4072389 Flujo Principal: -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid331756 \hich\af1\dbch\af0\loch\f1 1\tab}}\pard\plain \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid331756 El Prestador}{\f1\fs20\insrsid9206653 env\'eda }{ -\b\f1\fs20\insrsid9206653\charrsid1194460 informaci\'f3n de prestaciones e intervenciones}{\f1\fs20\insrsid9206653 de los afiliados.}{\f37\insrsid7029692\charrsid9206653 -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653 \hich\af1\dbch\af0\loch\f1 2\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653 El Sistema }{\f1\fs20\insrsid10759101 valida cada linea de la informaci\'f3n recibida; si la linea pasa la validaci\'f3n, se }{ -\f1\fs20\insrsid9206653 registra }{\f1\fs20\insrsid10759101 en el sistema la prestaci\'f3n realizada por el afiliado.}{\f37\insrsid9206653\charrsid9206653 -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653\charrsid9206653 \hich\af1\dbch\af0\loch\f1 3\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653\charrsid9206653 El Sistema, en base a \'e9stos datos}{\f1\fs20\insrsid10759101 y el resultado de la validaci\'f3n}{ -\f1\fs20\insrsid9206653\charrsid9206653 , construye un }{\b\f1\fs20\insrsid9206653\charrsid8981056 informe de aprobaciones/rechazos de prestaciones}{\f1\fs20\insrsid9206653\charrsid9206653 }{\b\f1\fs20\insrsid10759101\charrsid10759101 realizadas}{ -\f1\fs20\insrsid10759101 }{\f1\fs20\insrsid9206653\charrsid9206653 y lo env\'eda a Pagos -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid10759101 \hich\af1\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid10759101 Se llama al Caso de Uso \'93Generar Reporte de Consumo\'94}{\f1\fs20\insrsid9206653 -\par }\pard \s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289\pararsid9206653 {\f37\insrsid9206653 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 -\fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\f37\insrsid4072389 \trowd \irow4\irowband4\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 -\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard\plain -\s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289\pararsid7029692 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f37\insrsid4072389 -\par }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 \fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\b\f37\fs20\noproof0\insrsid4072389 Flujos Alternativos:}{\b\f37\fs20\noproof0\insrsid10759101 }{ -\f37\fs20\noproof0\insrsid10759101\charrsid10759101 No hay}{\f37\fs20\noproof0\insrsid10759101 .}{\b\f37\fs20\noproof0\insrsid7029692\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { -\f37\noproof0\insrsid4072389 \trowd \irow5\irowband5\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 -\clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 - -\par }{\b\f37\fs20\noproof0\insrsid4072389 Flujos de Excepci\'f3n:}{\b\f37\fs20\noproof0\insrsid10759101 }{\f37\fs20\noproof0\insrsid10759101\charrsid10759101 No hay}{\f37\fs20\noproof0\insrsid10759101 .}{\b\f37\fs20\noproof0\insrsid4072389 -\par }\pard \ql \fi-360\li646\ri0\nowidctlpar\intbl\faauto\rin0\lin646\pararsid8586758 {\f37\noproof0\insrsid8586758\charrsid8586758 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 -\trowd \irow6\irowband6\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 -\clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 -\trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\pard -\ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f1\noproof0\insrsid4072389\charrsid9206653 -\par }{\b\f1\fs20\noproof0\insrsid4072389\charrsid9206653 Notas:}{\b\f1\fs20\noproof0\insrsid6974674\charrsid9206653 }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 \~\~\~ }{\cs16\f1\fs20\insrsid10759101 - La comunicaci\'f3n Prestador-Sistema podr\'eda ser -\'93sincr\'f3nica\'94 (el prestador accede al Sistema y carga la informaci\'f3n) \'f3 bien \'93asincr\'f3nica\'94 (el Prestador env\'eda un mail, deja un archivo en un FTP, etc y luego el sistema lo procesa con alg\'fan m\'e9todo scheduleado.)}{ -\f1\noproof0\insrsid6974674\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl -\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 -\cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid4072389 -\par }{\insrsid15751489 Especificaci\'f3n de Datos:}{\insrsid1194460 -\par }{\insrsid15751489 -\par }{\f1\fs20\insrsid8981056\charrsid8981056 1) }{\b\f1\fs20\insrsid1194460 I}{\b\f1\fs20\insrsid1194460\charrsid1194460 nformaci\'f3n de prestaciones e intervenciones}{\b\f1\fs20\insrsid1194460 -\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid3805781 {\insrsid1720812 a) Identificaci\'f3n de Prestador (n\'famero de CUIT) }{\insrsid1720812 {\field{\*\fldinst SYMBOL 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid1720812 - es posible no incluirlo -\par b}{\insrsid12537211 ) C\'f3digo de autorizaci\'f3n relacionada a la }{\insrsid12537211\charrsid1275109 prestaci\'f3n/intervenci\'f3n}{\insrsid12537211 .}{\insrsid5050019 }{\insrsid8981056 -\par }{\insrsid1720812 c) C\'f3digo de prestaci\'f3n/intervenci\'f3n }{\insrsid1720812\charrsid1720812 (\'93Pr\'e1ctica\'94, en el nomenclador)}{\insrsid1720812\charrsid1275109 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid3948734\charrsid1275109 \tab }{\insrsid1720812 c}{\insrsid3948734\charrsid1275109 ) Fecha de R}{\insrsid3805781 ealizaci\'f3n}{\insrsid3948734\charrsid1275109 de la prestaci\'f3n/intervenci -\'f3n }{\insrsid3948734 -\par }{\insrsid1720812 \tab d) Porcentaje de cobertura a cubrir por la Obra Social.}{\insrsid1720812\charrsid1275109 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid3948734\charrsid1275109 \tab }{\insrsid1720812 e}{\insrsid3948734\charrsid1275109 ) N\'famero de afiliado}{\insrsid1720812 . }{\insrsid1720812 {\field{\*\fldinst SYMBOL - 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid1720812 es posible no incluirlo}{\insrsid3948734\charrsid1275109 -\par }{\insrsid3948734 -\par 2) }{\b\f1\fs20\insrsid3948734\charrsid986895 I}{\b\f1\fs20\insrsid3948734\charrsid8000756 nforme de aprobaciones/rechazos de prestaciones}{\b\f1\fs20\insrsid3948734 -\par }{\insrsid1720812\charrsid6241672 \tab a) Identificaci\'f3n del Prestador +\fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 \snext15 Predeterminado;}{\s16\ql \li0\ri0\sa120\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon15 \snext16 Cuerpo de texto;}{ +\s17\ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon16 \snext17 Lista;}{\s18\ql \li0\ri0\sb120\sa120\nowidctlpar\faauto\rin0\lin0\itap0 +\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon15 \snext18 Etiqueta;}{\s19\ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon15 \snext19 \'cdndice;}{ +\s20\ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon16 \snext20 Contenido de la tabla;}{\s21\qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 +\b\i\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon20 \snext21 Encabezado de la tabla;}{\*\cs22 \additive RTF_Num 2 1;}{\*\cs23 \additive RTF_Num 3 1;}{\*\cs24 \additive RTF_Num 3 2;}{\*\cs25 \additive RTF_Num 3 3;}{\*\cs26 \additive +RTF_Num 3 4;}{\*\cs27 \additive RTF_Num 3 5;}{\*\cs28 \additive RTF_Num 3 6;}{\*\cs29 \additive RTF_Num 3 7;}{\*\cs30 \additive RTF_Num 3 8;}{\*\cs31 \additive RTF_Num 3 9;}{\*\cs32 \additive \loch\f3 RTF_Num 4 1;}{\*\cs33 \additive \loch\f2 RTF_Num 4 2;} +{\*\cs34 \additive \loch\f10 RTF_Num 4 3;}{\*\cs35 \additive \loch\f3 RTF_Num 4 4;}{\*\cs36 \additive \loch\f2 RTF_Num 4 5;}{\*\cs37 \additive 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+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid7562310\charrsid13056714 El Prestador env\'eda }{\b\f1\fs20\insrsid7562310\charrsid13056714 informaci\'f3 +n de prestaciones e intervenciones}{\f1\fs20\insrsid7562310\charrsid13056714 de los afiliados. +\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 2\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720\pararsid7757395 {\f1\fs20\insrsid7562310\charrsid13056714 El Sistema valida cada l}{\f1\fs20\insrsid7757395\charrsid13056714 \'ednea de la informaci\'f3n recibida. Validaciones + sobre la info recibida: +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}\pard \s15\ql \fi-360\li829\ri0\nowidctlpar\intbl\jclisttab\tx829\faauto\ls3\rin0\lin829\pararsid7757395 { +\f1\fs20\insrsid13056714 La}{\f1\fs20\insrsid7757395\charrsid13056714 autorizaci\'f3n existe en el Sistema. +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid13056714 La}{\f1\fs20\insrsid7757395\charrsid13056714 autorizaci\'f3n }{\f1\fs20\insrsid13056714 est +\'e1}{\f1\fs20\insrsid7757395\charrsid13056714 relacionada con la prestaci\'f3n descripta por el Prestador. +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}La autorizaci\'f3n deber ser una que est\'e9 aprobada. +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}Porcentaje de cobertura }{\f1\fs20\insrsid13056714 debe ser igual al}{ +\f1\fs20\insrsid7757395\charrsid13056714 que se aplicaba al momento de la aprobaci\'f3n de la autorizaci\'f3n +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}\pard \s15\ql \fi-360\li829\ri0\nowidctlpar\intbl\jclisttab\tx829\faauto\ls3\rin0\lin829\pararsid11668463 { +\f1\fs20\insrsid13056714 Prestador debe ser el mismo que}{\f1\fs20\insrsid7757395\charrsid13056714 }{\f1\fs20\insrsid13056714 e}{\f1\fs20\insrsid7757395\charrsid13056714 l relacionado con la autorizaci\'f3n en el Sistema}{\f1\fs20\insrsid7562310 +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid13056714 El afiliado debe estar relacionado con la autorizaci\'f3n recibida.}{ +\f1\fs20\insrsid13056714\charrsid13056714 +\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid11668463\charrsid13056714 \hich\af1\dbch\af0\loch\f1 3\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid11668463\charrsid13056714 Si la l\'ednea pasa la validaci\'f3n, se registra en el sistema la prestaci\'f3n realizada por el afiliado. S +ino, se la marca como linea rechazada. +\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310\charrsid13056714 El Sistema, en base a estos datos y el resultado de la validaci\'f3n, construye un }{\b\f1\fs20\insrsid7562310\charrsid13056714 +informe de aprobaciones/rechazos de prestaciones}{\f1\fs20\insrsid7562310\charrsid13056714 }{\b\f1\fs20\insrsid7562310\charrsid13056714 realizadas}{\f1\fs20\insrsid7562310\charrsid13056714 y lo env\'eda a Pagos +\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 5\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310\charrsid13056714 Se llama al Caso de Uso \'93Generar Reporte de Consumo\'94 +\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 6\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310\charrsid13056714 Finaliza caso de uso. +\par }\pard \s15\ql \li289\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin289 {\f1\fs20\insrsid7562310\charrsid13056714 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 +\fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\f1\fs20\insrsid7562310\charrsid13056714 \trowd \irow4\irowband4\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl +\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard\plain \s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289 +\fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid7562310\charrsid13056714 +\par }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 \fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\b\f1\fs20\insrsid7562310\charrsid13056714 Flujos Alternativos: }{\f1\fs20\insrsid7562310\charrsid13056714 No hay.\cell +}\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\fs20\insrsid7562310\charrsid13056714 \trowd \irow5\irowband5\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt +\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 { +\f1\fs20\insrsid7562310\charrsid13056714 +\par }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Flujos de Excepci\'f3n: }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 No hay. +\par }\pard \ql \fi-360\li646\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin646 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { +\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \trowd \irow6\irowband6\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb +\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 +\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Notas: }{\cs68\f1\fs20\lang11274\noproof0\langnp11274\insrsid7562310\charrsid13056714 \~\~\~ - La comunicaci\'f3 +n Prestador-Sistema podr\'eda ser \'93sincr\'f3nica\'94 (el prestador accede al Sistema y carga la informaci\'f3n) \'f3 bien \'93asincr\'f3nica\'94 (el Prestador env\'eda un mail, deja un archivo en un FTP, etc y luego el sistema lo procesa con alg\'fan m +\'e9todo scheduleado.)}{\f1\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 +\trowd \irow7\irowband7\lastrow \ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 +\cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 +\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Especificaci\'f3n de Datos: +\par }{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 +\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 1) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informaci\'f3n de prestaciones e intervenciones}{ +\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 a) Identificaci\'f3}{\fs20\lang1024\langfe1024\langnp11274\insrsid13056714 n de Prestador (n\'famero de CUIT)}{ +\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 +\par b) C\'f3digo de autorizaci\'f3n relacionada a la prestaci\'f3n/intervenci\'f3n. +\par c) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94, en el nomenclador) +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab c) Fecha de Realizaci\'f3n de la prestaci\'f3n/intervenci\'f3n +\par \tab d) Porcentaje de cobertura a cubrir por la Obra Social. +\par \tab e) N\'famero de afiliado. +\par +\par 2) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informe de aprobaciones/rechazos de prestaciones}{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid13056714 realizadas}{ +\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 +\par \tab a) Identificaci\'f3n del Prestador \par \tab b) Nombre del Prestador -\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid6241672 {\insrsid1720812\charrsid6241672 c) C\'f3digo de autorizaci\'f3n }{\insrsid1720812\charrsid6241672 relacionada a la prestaci\'f3n/intervenci\'f3n}{\insrsid6241672 , enviada por el - Prestador.}{\insrsid1720812\charrsid6241672 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid15751489 {\insrsid15751489\charrsid6241672 \tab }{\insrsid6241672\charrsid6241672 d}{\insrsid15751489\charrsid6241672 ) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94 -, en el nomenclador) -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid8000756\charrsid6241672 \tab }{\insrsid1720812\charrsid6241672 e) }{\insrsid6241672\charrsid6241672 Identificador de linea Aprobada/Rechazada}{\insrsid3886421\charrsid6241672 - -\par }{\insrsid6241672\charrsid6241672 \tab f) }{\insrsid6241672 C\'f3digo de afiliado +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 c) C\'f3digo de autorizaci\'f3n relacionada a la prestaci\'f3n/intervenci\'f3n, enviada por el Prestador. +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab d) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94, en el nomenclador) +\par \tab e) Identificador de l\'ednea Aprobada/Rechazada +\par \tab f) C\'f3digo de afiliado \par \tab g) % cobertura reclamado por el prestador -\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid6241672 {\insrsid6241672 h) % cobertura correspondiente al momento de aprobar la autorizaci\'f3n (si la autorizaci\'f3n existe en el sistema) -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid6241672 \tab }{\insrsid662813 i) F}{\insrsid6241672 echa de aprobaci\'f3n de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) -\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid6241672 {\insrsid6241672 j}{\insrsid662813 ) F}{\insrsid6241672 echa de vencimiento de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) -\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid662813 {\insrsid662813 k) Motivo del rechazo de la linea (ej: \'93Autorizaci\'f3n recibida inexistente\'94, \'93Autorizaci\'f3n Vencida\'94, \'93% cobertura recibido inv\'e1lido\'94, etc)} -{\insrsid6241672 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid6241672 \tab }{\insrsid1720812\charrsid662813 -\par }{\insrsid3886421\charrsid6241672 3) }{\b\insrsid3886421\charrsid6241672 Reporte de consumo de los afiliados}{\b\insrsid3948734 -\par }{\b\insrsid662813 \tab Cada linea:}{\insrsid662813\charrsid6241672 -\par {\listtext\pard\plain\lang1024\langfe1024\noproof\langnp2058\langfenp2058\insrsid3886421\charrsid6241672 \hich\af0\dbch\af0\loch\f0 a)\tab}}\pard \ql \fi-360\li1065\ri0\nowidctlpar\jclisttab\tx1065\faauto\ls5\rin0\lin1065\itap0\pararsid662813 { -\insrsid3886421\charrsid6241672 N\'famero de afiliado}{\insrsid3948734 -\par {\listtext\pard\plain\lang1024\langfe1024\noproof\langnp2058\langfenp2058\insrsid662813 \hich\af0\dbch\af0\loch\f0 b)\tab}}{\insrsid662813 Nombre, apellido del afiliado -\par }\pard \ql \li1065\ri0\nowidctlpar\faauto\rin0\lin1065\itap0\pararsid662813 {\insrsid662813 Por cada afiliado: -\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid662813 {\insrsid662813 c}{\insrsid3886421\charrsid6241672 ) C\'f3digo de prestaci\'f3n/intervenci\'f3n REALIZADA}{\insrsid3886421 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid662813 \tab d) Nombre de la prestaci\'f3n realizada -\par \tab e) C\'f3digo del plan del afiliado -\par \tab f) % Cobertura}{\insrsid662813\charrsid6241672 +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 h) % cobertura correspondiente al momento de aprobar la autorizaci\'f3n (si la autorizaci\'f3n existe en el sistema) +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab i) Fecha de aprobaci\'f3n de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) +\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 j) Fecha de vencimiento de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 k) Motivo del rechazo de la l\'ednea (ej: \'93Autorizaci\'f3n recibida inexistente\'94, \'93Autorizaci\'f3n Vencida\'94, \'93 +% cobertura recibido inv\'e1lido\'94, etc) +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab \par }} \ No newline at end of file